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D.I.Y. abortions

A Massachusetts teenager is in trouble after her attempt to self-induce abortion failed:

An abortion was out of the question. [Amber] Abreu, 18, had done that once already. She couldn’t ask her mother to pay for that again. Her mother, a Venezuelan immigrant who wanted so much for her children, would be devastated.

It's interesting that Abreu didn't consider taking the pills -- which a friend brought her from the Dominican Republic -- to be the same thing as having an abortion. In a study of Latina immigrants and their relationship with self-induced abortion using Cytotec, many said they considered taking the pills "better" than surgical abortion, or not an abortion at all.

[Abreu] did not contact social service workers or community organizations. She had learned nothing about birth control or what to do if she became pregnant again. She received no prenatal care. She took the Cytotec.

This is what happens when abortion is both incredibly expensive and stigmatized -- women turn to DIY methods. And sometimes they backfire. Abreu's story reminded me of Gabriela Flores, a Mexican immigrant who was arrested for self-inducing abortion using the same drug, was initially charged with murder. The charges were later reduced to "illegal abortion." Abreu may face homicide charges.

There's a reason Cytotec is a popular abortion method in countries where abortion is illegal, such as the Dominican Republic (where Abreu's pills came from). In Latin America, Cytotec is commonly sold over-the-counter and costs only a few dollars per pill. International repro health organizations like Ipas are doing important outreach work educating women when and how they can safely have abortions using Cytotec (misoprostol) alone. If doctor-supervised abortion isn't an option, and when proper doses are used at the right point in pregnancy, it can be a safe and effective way to have a DIY abortion. But it's bad news when women like Abreu get the pills without all the information.

Posted by Ann - January 26, 2007, at 03:53PM | in International , News , Reproductive Rights

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23 Comments

That is a truely heart-breaking story. This is why we must fight for every woman's right to choose. This is why we must fight to educate people, not only about safe sex and contraception, but also to available resources and what organizations to turn to for help. The Planned Parenthood in my area offers sliding scale fees based on income for people without medical insurance and are willing to work out a payment plan if necisary. I'm sure other Planned Parenthoods offer similar services.

It is a shame that women are so ashamed by the stigma of having an abortion that they will go to such extreme measures. I consider myself very lucky that I have grown up with abortion legal. Cases like this remind me exactly how much more work needs to be done to ensure that every woman has access to services and information to make choices about her body.

Legally speaking, I'm not sure if a homocide charge can stick (I'm not a lawyer, so maybe someone more law-savvy can help us out. Law Fairy - I'm looking at you). A homocide would indicate that she murdered another human. Abreau took the Cytotec at about 4 months into the pregnancy (first missed period in September, pills taken in December) and then gave birth a very premature, but live, child in January. The child then died in the hospital. TO me, this is different than an assault victem later dying of injuries suffered in the assault. The prosecution will need to argue that a fetus is indeed a human at this stage in the pregnancy. This brings up the 'life begins at conception' argument and also views other forms of abortion as murder as well. That's a scary argument in my opinion. Out of curiosity, are woman who miscarry due to drug or alcohol abuse routinely get charged with homicide?

Also, as an aside, I don't see how sitting with your face buried in your hands can be considered a 'nonchalant' attitude. And why did the article have to mention her 'clean, well furnished home'? Is this to indicate that the girl could have been able to afford a more conventional abortion?

And the anti-choice people actually think that women use abortion as birth control...ugh.

That's what really bugs me about the anti-choice movement. They limit access to birth control and sex education, spend more time judging girls and women rather than helping them, and then they're surprised to see young girls going to such drastic measures to get rid of their babies?

And I'm with you, VT. I don't think the girl will be able to be charged with homicide, especially not in MA. (At least I hope not.)

[0+|0-] Author Profile Page kpsisu said:

What a nightmare. This is what happens with abstinence only education.

[0+|0-] Author Profile Page Laina said:

Mary B,

abortion *is* birth control. It keeps births from happening, therefore it is birth control.

What abortion is NOT: a routine "standard" form of birth control used regularly by a woman, such as hormonal contraceptive pills or condoms.

I noticed the same things in the article VT Idealist did - the mention of the girl's home (would they have mentioned or even noticed a "clean, well-furnished home" if the girl's name had been Brooke Jones or something?), and also wonder on what planet someone burying their face in their hands is "nonchalant." The whole attitude in this article is offensive as hell.

Also, does MA have those 'sanctuary' laws in place? The thing where a girl can leave her baby at a hospital or other designated place and she won't be charged with abandonment? Because if they do - how is it that this girl's actions don't count? I mean, they tracked her down and made her take responsibility for this baby anyway, when she'd already left it at the hospital and made it clear she didn't want it?

And people think feminists have nothing left to fight for. snort!

Laina:

Yes that's what I meant, a regular form of birth control. The way anti-choicers paint the issue, they think women just go to the clinic every other weekend and pop a fetus out, then go back to their dens of debauchery to have more sex.

[0+|0-] Author Profile Page Tokaia said:

Mary said:

"That's what really bugs me about the anti-choice movement. They limit access to birth control and sex education, spend more time judging girls and women rather than helping them, and then they're surprised to see young girls going to such drastic measures to get rid of their babies?"

Those people don't want anyone having sex for any reason other than to procreate.

Another possible (and VERY likely) aspect that's not mentioned; religion.

Probably raised Roman Catholic.

Gotta love the faith! And the faithful!

[0+|0-] Author Profile Page Tokaia said:

"

Laina:

Yes that's what I meant, a regular form of birth control. The way anti-choicers paint the issue, they think women just go to the clinic every other weekend and pop a fetus out, then go back to their dens of debauchery to have more sex."

*Snort* As if anyone can afford to do that unless they're rich... The day I treat a procedure that takes all of 5 minutes yet costs $400 like buying an ice cream cone is going to be a cold day in hell.

[0+|0-] Author Profile Page Kate said:

Unfortunately I think we're going to see more and more cases like this if the anti-choice people have their way and abortion becomes limited or restricted in certain states/areas. I'm wondering if this girl had abstinence-only education in her school? It would be interesting to know. Just goes to show that kids are going to have sex regardless of faith or whether true sex ed (which includes birth control information) is provided. Just because someone says that they should abstain doesn't mean they will.

I would definitely agree that taking misoprostol is not like having a surgical abortion and would describe it as "better" (as an experience, not having anything to do with ethics).

The homicide charges are ridiculous, and I sincerely hope she won't be sitting in jail until her court date on the 25th of February. But I don't think this one can be blamed on abortion laws or a lack of information. This happened in Massachussets, not South Dakota. The article indicates that she was unaware of the help available to her by the state. But this information is not that hard to come by. She was a college student and therefore perfectly capable of looking into state social services and researching misoprostol induced abortion (which can only be done in the first 8 weeks of pregnancy).

At the point of her miscarriage, she would have still been eligible for a surgical abortion (up to 19 weeks at the Planned Parenthood) so I don't see how one could argue it was a homicide.

In less than half an hour I was able to find out that Massachussets will cover the cost if the patient is under 20 (regardless of income) or over 20 and earning less than 200% of the national poverty level. MassHealth (medicaid) is accepted at Planned Parenthood Mass, which offers abortions at three of its locations.

Conditions were all set up in her favor, but she didn't bother to look into it any more than she (presumably) looked at the directions on the home pregnancy test she took. What more could the state have done... run primetime TV commercials letting people know about eligibility for state funded abortions? She dropped the ball on this one, but I don't think she should be punished for it.

VT, to answer the question -- it depends (how's that for a lawyer answer? ;) ).

I'm not familiar with Massachusetts homicide laws. Unfortunately, since this occurred in the second trimester (and apparently after fetal viability, if the baby was able to survive for four days), it isn't automatically protected by Roe (if I recall correctly -- I know that restrictions on third trimester abortions are definitely okay, and I'm pretty sure on second trimester as well. I'm almost positive that viability makes more restrictions acceptable). Lots of subsequent Supreme Court cases have slowly cut back protections for abortions -- this is why a lot of states are able to have parental consent and/or notification laws, etc.

That said, I'd be very surprised if the language of Massachusetts' homicide statute allowed for such a construction. The Model Penal Code defines "homicide" as "the act of purposefully, knowingly, recklessly, or negligently causing the death of another human being." I imagine Massachusetts' statute is similar if not identical -- so you're right that they would probably need to consider whether the fetus was "human."

Where it could get interesting: if they prosecute under the homicide statute, the defense will probably point out that any action taken to harm the fetus was taken while it was still in the mother's womb. Thus, the court would truly have to answer that an unborn fetus is a "human being" within the purview of the Massachusetts homicide statute, in order to find her guilty. This would be a pretty sweeping finding, because it opens up the possibility that a pregnant mother who wears strappy sandals and trips, inducing premature labor and resulting in death of the fetus/child, may have been criminally negligent. A man who beats a pregnant woman and induces a miscarriage would be guilty of intentional homicide (though I can't say this one bothers me much :)). A pregnant mother who drinks during her pregnancy (btw, a small amount of alcohol -- say a glass of wine with dinner -- generally doesn't harm a fetus) might even be found guilty of serving alcohol to a minor.

Keep in mind of course that the fetus would have to be a certain age in these scenarios. Any homicide ruling would only apply to fetuses of/over a certain age, or the ruling would risk running afoul of Roe.

These are pretty far-out examples, sure. And they'd almost never be prosecuted this way (except for, possibly, the abusive husband/boyfriend). But it seems to me these would be necessary implications of a finding that a fetus is a human. Since the mother took action WHILE the fetus was still unborn, a homicide conviction would constitute a finding that an unborn fetus qualifies as a "human being" for purposes of the statute.

One possibility is that Massachusetts' homicide law is specially crafted to count abortions after week 24 as "homicide." This spares us the problem of figuring out whether an unborn fetus qualifies as a regular "human being" for purposes of the statute. Of course, for all I know they've already found that it does in order to make 24 week+ abortions illegal. I suspect, however, there's a separate statute and/or provision that specifically does this, to avoid the sorts of implications I discussed above.

Oh man, it is tempting to get into even more complicated hypothetical legal analysis... I love this stuff. But I have real work I really ought to turn my attention to ;)

My final thought: she'll ultimately be prosecuted for an illegal abortion or the equivalent, or, if the DA has a soul, for nothing or for a slap on the wrist charge. No DA really wants to fight the uphill battle it would be to make a botched abortion qualify as "homicide," especially where the defendant is a teenage girl. Unless s/he/it has right wing political aspirations, in which case even a loss might be a boon.

[0+|0-] Author Profile Page JustAnotherJane said:

So...if she's convicted, and if it makes it to appellate court, could it become case law that establishes a dangerous precedent? I know that's unlikely, but still. God it freaks me out I even have to ask. I am astonished that she was charged with anything.

FrenchKiss, I disagree that she had everything in her favor. I really couldn't get a good grasp from the article what she did and did not know about available resources. Let's not assume this was simply a lack of motivation or effort. It could be -- but it could also be that her upbringing, education, her access to the internet, her research skills, her network of help/etc was not the same as for you and I.

Either way, I do agree with you that she shouldn't be punished.

I'd like to know if she received any information about birth control at the time she got the first abortion. It seems to me it would be pretty logical for abortion providers to provide information and counseling about birth control, so that the woman is less likely to need another abortion. Does anyone know what's typical along these lines?

[0+|0-] Author Profile Page cherylp said:

I also disagree that she 'dropped the ball' - the story makes it seem like she was scared and unsure what to do. Until there's no shame associated with unplanned pregnancy, this will continue to happen, sadly. We also shouldn't assume that it was her fault the pregnancy test wasn't accurate - some women produce less of the hormone than others, and there are better times of the day/conditions to get an accurate result. Even under perfect conditions, they still have a failure rate.

Also, I wouldn't say that using misoprostol for an abortion is better than surgical abortion as an experience (at least not for everyone). The most common reason that women choose a medical abortion is that it seems more natural (i.e. like a miscarriage), and it can be experienced at home and privately and with support from friends/family, or alone if the woman so chooses. But for most people, it's in no way better physically - it can be quite painful and can knock you off your feet for several days (not always, but often). The surgical abortion is usually much more discrete in this respect because the procedure is quick and most women are back to themselved much quicker. So neither is "better", they're just different, and women prefer one or the other for different reasons.

As far as women getting contraception advice after an abortion - I'm in Canada so I'm not sure if it's the same in the US (or in other parts of Canada for that matter...) - but abortion clinics here do have a conversation about contraception and even provide 3 months free of whatever type she wants (i.e. the pill, ring, patch, or a healthy supply of condoms, etc.). The woman can refuse this part of the 'counselling' though, and the nurses don't force the issue (of course) - so it's a choice still.

[0+|0-] Author Profile Page Kyra said:

Abreau took the Cytotec at about 4 months into the pregnancy (first missed period in September, pills taken in December) and then gave birth a very premature, but live, child in January. The child then died in the hospital. TO me, this is different than an assault victem later dying of injuries suffered in the assault.

Exactly. The child died because it was not viable. I suspect (though I am not sure) that Massachusetts' 24-week cutoff is mostly justified by viability concerns, and it seems to me that if a child is viable enough to outlaw abortion in that case, then it's viable enough to be given birth to and survive.

The pregnant woman removes herself from interaction with the fetus, which is her right. If it's viable, it lives, and the procedure is called "giving birth." If it's not viable, it doesn't live, and the procedure is called "abortion." I don't see that viability can be a valid excuse to outlaw abortion before it's actually viable. The law is flawed.

[0+|0-] Author Profile Page Sylke said:

What really scares me is the fact that pro-choice groups feel the need to hide the efficicy of misoprostol in abortion for fear that the pro-lifers will jump all over it and try to outlaw it as well. Doesn't the fact that thousands of women want it, and are willing to get it illegally, prove that their restrictive thinking is doing nobody any good? I guess it would be too much for pro-lifers to acknowledge that little thing called reality, though.

I would be interested to see if Abrea's schooling consisted of abstinence education.

[0+|0-] Author Profile Page Kuri said:

It seems to me that cases like this are the perfect argument for universal health care. Abortion is a necessary medical service. Necessary medical services shouldn't carry charges at all. In the majority of developed countries they do not.

[0+|0-] Author Profile Page bridgetka said:

Where it could get interesting: if they prosecute under the homicide statute, the defense will probably point out that any action taken to harm the fetus was taken while it was still in the mother's womb. Thus, the court would truly have to answer that an unborn fetus is a "human being" within the purview of the Massachusetts homicide statute, in order to find her guilty. This would be a pretty sweeping finding, because it opens up the possibility that a pregnant mother who wears strappy sandals and trips, inducing premature labor and resulting in death of the fetus/child, may have been criminally negligent. A man who beats a pregnant woman and induces a miscarriage would be guilty of intentional homicide (though I can't say this one bothers me much :)). A pregnant mother who drinks during her pregnancy (btw, a small amount of alcohol -- say a glass of wine with dinner -- generally doesn't harm a fetus) might even be found guilty of serving alcohol to a minor.

National Advocates for Pregnant Women has some horror stories about women who used drugs/alcohol during their pregnancies being prosecuted for providing drugs to a minor, child abuse, child endangerment, and homicide.

This Mother Jones article has a good overview.

The only thing this case shows is that a) an abortion pill should not cost $400 a pop and only be available at locations like Planned Parenthood, which by the way to anyone who claims that their existence makes abortion accessible to those who don't have alot of money need to re-think that claim because Planned Parenthood only has location in urban areas, which can be hard for rural or poor women to get to. Plus, some states now have 24 hour waiting periods which mean women have to travel to such locations more then once, take off from work or school more then once and pay for transportation costs more then once. b) That our government has a screwed up perception of human life and murder. I doubt she would have been accused of murder had she been a drug addict, alcoholic, smoked, didn't take prenatal vitamins or anything else that could have caused the death of her fetus.

[0+|0-] Author Profile Page K-ten said:

i know this doesn't have that much to do with the post, but i was searching the web for information on abortion for a paper i am writing. The paper has to be non-biased so i was looking for neutral info, and i went to the first site off a google search http://www.abortionfacts.com/ after just reading two links off of that site i felt like such an abombanation on society for being pro-choice. It is a good thing i wasn't actually pregnant and looking for support because they actually use terms such as "evil/violent act" and answering the adoption question by "Which is better to remember, 'I gave my baby life. And because I loved him, I gave him into the arms of a loving couple' - or to remember, 'I selfishly ended my baby's life?'"

[0+|0-] Author Profile Page laguz said:

does anyone know if any feminist organizations (NARAL, Planned Parenthood)are offering to help out with the legal costs?

[0+|0-] Author Profile Page laguz said:

I'm new to blogging, but what is going on in Massachusetts (my proud Commonwealth)movtivated me. I checked around on some of the better know "lefty" blogs, including bluemass group. So I posted. and I got gross comments by bloggers who say what this woman did was "infantacide". Really. Check it out.

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